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General NPI Number Information
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NPI Number | 1780322982
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Entity Type | Organization
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Legal Business Name | AUGUSTA WAYS HOLDINGS LLC
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Dates
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Enumeration Date | 05/26/2022
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Last Update Date | 05/27/2022
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Provider Practice Location Address
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Address Line | 1349 DRUID PARK AVE
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City | AUGUSTA
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State | GA
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Zip | 30904-5723
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Country | US
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Telephone | 706-750-0322
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Fax |
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Provider Business Mailing Address
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Address Line | 3330 COBB PKWAY STE 17, UNIT 361
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City | ACWORTH
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State | GA
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Zip | 30101
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | CHRISTOPHER SCOTT MILLER
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Credential |
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Telephone | 334-685-1496
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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